Nursing shortage could kill you

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According to the American Hospital Association, 126,000 nursing jobs are vacant at American hospitals right now. Economists and demographers alike speculate that the race toward "senior living" by Baby Boomers will impact everything from soup to nuts. Numbers don't lie. Seventy-seven million people due to retire in the next 10 years will change wholesale industries like insurance and housing and shake Wall Street to its financial foundations.

In this vein, one item worth noting will be the enormous crush upon U.S. health care services. Boomers approaching retirement have already forced a national dialogue about how to save Social Security, strengthen Medicare and Medicaid, and rein in costs for prescription drugs. Indeed, the 2002 midterm elections were fraught with these issues.

But nearly overlooked in all this has been the crushing need for more nurses in this country and it won't be long before it's time to pay the piper. When we or someone we love takes ill, when a hospital, clinic or emergency room is required, the services of a nurse take a back seat to no one.

Remove the bedside activities of the nurse -- dispensing medications, offering encouragement and support, assisting physicians and yes, fluffing pillows -- and a hospital stay quickly descends from unpleasant to miserable. This is the very scenario now before us because of a severe nursing shortage that will only worsen without corrective action.

Right now, critical-care nursing is adequately staffed in most places in the country. But the same can no longer be said about nursing in many standard hospital environments, senior living facilities, skilled nursing facilities and home health agencies. The fact is that the current nurse work force is aging with increasing odds that younger nurses won't stay long enough to alter patterns anytime soon.

The average practicing RN today is nearly 44 years old; 20 years ago, that average age was more like 38. At the same time, enrollment in nursing programs has decreased consistently over the past five years. And almost 6 in 10 hospitals today are forced to hire temporary nurses whose familiarity with specific hospital protocol, staffing peculiarities and equipment usage all increase the likelihood of error.

Complicating this, a recent study presented to Congress found a staggering 5 in 10 nurses working today considered leaving their chosen occupation for reasons other than retirement. It's a minor relief that so many suggest their primary reason should be relatively easy to correct -- highest among them participation in decisionmaking and a desire to move hospitals toward patient-centered rather than insurance-centered environments.

This should come as no surprise to anyone who knows anything about the profession: Nurses are largely caring, nurturing types who get into the practice, basically, to help sick people feel better quicker. They're not in it for the money, but they need to be remunerated fairly. They're not in it for bragging rights, but they must feel their efforts are appreciated.

The time for health-care administrators and insurance companies to address this crisis is now. Health and Human Services Tommy Thompson, as compassionate a person as you could ever want, recently announced $30 million in grants to attract more people to this honorable profession. Most of that money was earmarked for colleges and universities.

And recently, the Senate approved a modification initiated by Sens. Susan Collins, Maine Republican, and Barbara Mikulski, Maryland Democrat, for additional nurse funding under the fiscal 2004 Labor, Health and Human Services and Education Appropriations bill (HR 2660). The amendment increases by $50 million the nursing work force development programs within Title VIII of the Public Health Service Act.

The U.S. House of Representatives now will have to concur with the Senate's modification.

These are excellent starts. But we need even more models and practices that will develop innovative strategies and approaches for retaining professional nurses. Some of these measures should include promoting nurse involvement in organizational and decisionmaking processes, advancing on-site collaboration and communication dynamics, promoting quality nursing care through the workplace environment while finding better ways to afford nurses increased education and career advancement.

The 60 Plus Association strongly supports HR 2660 on behalf of some 4.5 million citizens it relies on for support and hopes Congress takes up this legislation with the urgency it demands.

Update Medicare? Yes. Repair Social Security? Absolutely. Find a way to help seniors on fixed incomes afford prescription drugs? You bet.

But we had better get our collective arms around the impending crisis over the nurse shortage before someone we love -- or that person in the mirror -- is more than inconvenienced. Heck, our very lives may depend upon it.

James L. Martin is president of the 60 Plus Association in Arlington, Va.